1.
General and special patient preparation for the contrast procedures in Radiology
department
INTRODUCTION
Contrast procedures in radiology involve the use of contrast media to visualize the the
internal organs , vessels or tissues during imaging by enhancing them . These procedures are
vital for accurate diagnosis in modalities such as X- ray , fluoroscopy , CT, and MRI . Proper
patient preparation is essential to ensure the safety , accuracy and efficiency of these
procedures .
PREPARATION FOR GENERAL RADIOLOGICAL EXAMINATIONS
*Remove all metallic objects from ROI and wear hospital gown
*Explain the procedure to patient
*Get consent
*Follow 10 / 28 day rule for female patients
*Ensure proper patient positioning
PREPARATION FOR SPECIAL CONTRAST PROCEDURES
A) IVP
*Ask for any history for diabetes mellitus , pheochromocytoma , renal disease or allergy
to drugs or contrast media
*Fasting for 4hrs
*Consent form should be filled
*Bowel preparation
*Low residue diet
*Bowel wash is given till bowel is clear of fecal matter on previous night
*Remove any metal from ROI
*Patient blood urea and serum creatinine must be reviewed prior to the examination
B) RGU AND MCU
* On the day of examination explain the whole procedure to the patient.
*Technologist should obtain consent from the patient for permission of procedure.
*Ask the patient to remove clothing and metallic objects and wear hospital gown.
*An intravenous line is inserted into patient arm and sedative medication is given
*The patient should not eat or drink after midnight.
*Ask the patient to take low residual diet for two days.
*Bisacodyl and castor oil (laxatives) are given night before the examination to eliminate
fecal matter.
*Ask the patient to stop taking anticoagulant before exam.
C) HSG
Ideal time of procedure is between 8th and 10th day of menstrual cycle, i.e., 2-3 days
after stoppage of menstruation so that menstruation tissue or fluid is not carried either into the
oviduct or the peritoneal cavity and the incidence of intravasation of contrast is low. Done before
12th day because oocyte undergoes meiosis during this time and is radiosensitive. Thus radiation
exposure during this time should be avoided.
*The patient should be advised to abstain from intercourse between booking the
appointment and the time of examination unless a reliable method of contraception is
used to avoid the possibility of irradiating an early pregnancy.
* Patient should be fasting 4 hours prior to the procedure.
*Informed consent should be obtained.
*On the day of examination describe the whole procedure to the patient.
*Premedication is not required in majority of the cases. When the patient is very
anxious, 5-10 mg of I.V. diazeparn 30 minutes before procedure is helpful to prevent the
tubal spasm which can be provoked by anxiety. Morphine and Pethidine should not be
given as they stimulate the contraction of the fallopian tubes. However Baralgan, which
contains analgin and pitafemone HCl in 2 ml ampoule or 0.6 mg atropine sulphate in 1 ml
ampoule can be given I.V. 10 to 15 minutes before starting the procedure.
D) CHOLANGIOGRAPHY
*Describe the whole procedure to the patient.
*A fat free diet suggested to the patient, two days prior to the examination.
*Technologist should obtain consent from the patient for permission of procedure.
*The examination is done 7-10 days after operation/ earlier if there is indication for this
such as hemorrhage from T-tube/failure of T-tube drainage.
*All dressings and metallic objects are removed from the liver area and wear hospital
gown.
*A preliminary film of right upper quadrant should be obtained before injection to
establish the position of tube and identify unusual air collections.
*Nil orally for 6-8 h prior to procedure.
*Antibiotic cover for patients with biliary obstruction, pseudocyst or high risk of
endocarditis.
*Previous biliary track investigation report (T-tube cholangiography).
*Check the patient previous history, medication report.
*Check the liver function test report before the examination.
*The chest x-ray report, blood urea, serum creatinine, previous cholangiography report,
USG report, LFT report, bleeding disorder report and blood sugar report must be
reviewed by Radiologist and Gastroenterologist. (PTHC)
E) BARIUM STUDIES
* Describe the whole procedure to the patient before examination.
*Ask the patient to remove metallic object from scan area and wear hospital gown.
*Technologist should obtain consent from the patient for permission for procedure.
*Ask the patient to take low residual diet for two days prior to the examination.
*Laxative may be given to the patient, the night before examination.
*Instruct the patient, not to smoke or chew gum because it prevent proper
coating of barium sulphate on the mucosa.
F) CT SCAN
* Necessary tests
• creatinine and urea
*Preparation for the examination
• Light meal is allowed - 3 hours prior to the examination at the latest.
• Adequate hydration prior to the examination is required (still water, neutral
liquids).
*Drugs
• On the day of examination, all the routinely administered drugs should be taken.
• Patients treated with metformin preparations should discontinue its use 48 h
before and 24 h after the examination.
G) MRI
* Preparation for the examination
• Fasting status is not necessary.
• For the trunk examination, a two-piece outfit is recommended, devoid of any
metal elements. Any jewelry or removable bridge should be taken out. No external hearing
aids, keys, magnetic cards or mobile phones are allowed in the MRI examination room.
• Patients suffering from claustrophobia (fear of staying in small, confined spaces)
may take mild sedatives to reduce anxiety.
*Drugs
• On the day of examination, all the routinely administered drugs should be taken.
H) USG
*The preparation for this test will depend on the type of ultrasound procedure your doctor
has ordered. Some preparations include drinking a quart of water before the test to obtain
better images. Your doctor will instruct you.
*If you are having a biopsy, you will be asked to not eat or drink anything past midnight the
night before the exam. Your doctor will instruct you.
*Renal or Kidney Ultrasound Drink three 8 oz. glasses of water. You must finish drinking all of
the water 1 hour prior to arriving for your imaging study. DO NOT empty your bladder. NOTE:
These imaging studies require a full urinary bladder in order to be able to obtain a successful
image. If your bladder is not full at the time of your appointment, then your appointment
may be postponed/rescheduled. Pregnant patients should drink the water slowly.
*All dressings and metallic objects are removed from the scan area and wear hospital gown.
*Pelvis or Lower Abdomen, OG/GYN, Male Lower Ultrasound Studies
CONCLUSION
Proper general and special patient preparation is crucial for the success of contrast
procedures in radiology. It ensures patient safety, optimal image quality, and accurate
diagnosis. Radiology professionals must be vigilant, communicative, and follow established
protocols to minimize risks and enhance patient experience.
2. Explain the aseptic techniques and its significance in interventional procedures
INTRODUCTION
Interventional Radiology (IR) involves minimally invasive procedures performed using
image guidance such as ultrasound, fluoroscopy, CT, or MRI. These procedures often
involve puncturing the skin or entering sterile body cavities, which carries a risk of
infection. Therefore, maintaining aseptic (sterile) conditions is vital to prevent
complications like local or systemic infections. Antiseptic techniques are a crucial
component of patient safety and procedural success in IR.
Healthcare professionals use the aseptic technique to prevent contamination from
pathogens like bacteria and viruses. It involves applying the strictest rules during
medical procedures to minimize the risk of infection.
Aseptic technique types
There are four chief aspects of the aseptic technique: barriers, patient equipment
and preparation, environmental controls, and contact guidelines. Each plays an
important role in infection prevention during a medical procedure.
*Barriers
Barriers protect the patient from the transfer of pathogens from a healthcare worker,
from the environment, or from both. Some barriers used in aseptic technique
include:
sterile gloves
sterile gowns
masks for the patient and healthcare provider
sterile drapes
Sterile barriers are those that have not touched a contaminated surface. They’re
specially packaged and cleaned items. Healthcare workers put them on or use them
in specific ways that minimize exposure to germs.
*Patient and Equipment Preparation
Healthcare providers also use sterile equipment and sterile instruments. To further
protect the patient, they apply cleansing and bacteria-killing preparations to the
patient’s skin before a procedure.
*Environmental controls
Maintaining a sterile environment requires keeping doors closed during an operation.
Only necessary health personnel should be at the procedure. The more people
present, the more opportunities for harmful bacteria to cause contamination
*Contact guidelines
Once healthcare providers have on sterile barriers, they should only touch other
sterile items. They should avoid touching nonsterile items at all costs.
Aseptic technique vs. clean technique
*Keeping the environment as clean as possible is always important in preventing
infections. However, some situations call for aseptic technique while others call for
clean techniques.
*The goal of the aseptic technique is to eliminate germs entirely. The goal of the
clean technique is to reduce the number of germs whenever possible. Clean
techniques are important for all healthcare providers and their patients because they
prevent infections every day.
*Examples of clean techniques include washing hands and putting on clean gloves
when needed. Healthcare providers keep a patient’s surroundings as clean as
possible, but they aren’t using sterile items or aseptic technique.
Additional Measures for Infection Control
[Link] Antibiotics
• Used selectively depending on the type of procedure and patient risk
factors (e.g., biliary interventions, abscess drainage).
• Must be administered 30–60 minutes before the procedure.
[Link] and Protocol Adherence
• Continuous staff education and simulation training on sterile
technique.
• Standard operating procedures (SOPs) should be in place and followed
strictly.
[Link] Contaminations
• If a sterile field is breached, the contaminated item must be replaced
immediately.
• Any suspected contamination must be reported, and corrective
actions taken.
CONCLUSION
Antiseptic techniques in interventional radiology are not optional—they are critical
safeguards that ensure patient safety, minimize infection risks, and improve procedural
outcomes. Strict adherence to hand hygiene, sterile barrier precautions, patient skin
antisepsis, and sterile equipment handling are the foundation of infection prevention in IR.
Radiology professionals must be well-trained and vigilant in applying these techniques
consistently.
3. Responsibility of a radiographer during radiological procedures
INTRODUCTION
The radiographer plays an essential role in diagnostic imaging. A radiographer is responsible for
producing high-quality radiographs, protecting the patient's safety and comfort, and ensuring
patient confidentiality. Responsibilities also include dealing with care across clinical, technical,
ethical and legal aspects. With the continuing development of imaging technology, the
radiographer must ensure they are competent to perform any and all imaging procedures,
meanwhile, be vigilant and patient-centred in all dealings with all patients
1. Patient Identification and Verbal Communication
Where possible, identify the patient with at least 2 identifiers (e.g., name, date of birth, ID
band).
Explain the procedure in a language appropriate to the patient, clarify any concerns, and
gain consent (informed).
Follow a structured approach to identify and guide the patient through all communications,
including those with vulnerable groups (e.g., neonate, geriatric, underdeveloped, non-
verbal).
2. Patient Positioning and Preparation
Ensure you prepare the patient both physically and mentally for the procedure
Remove any unnecessary artifacts (e.g., jewelry, clothes).
Determine that the patient has adhered to the pre-procedure state, where applicable (e.g.,
fasting, bladder preparation).
3. Radiation Protection
Promote and adhere to ALARA (As Low As Reasonably Achievable) principles
adhere to the ALARA principles (As Low As Reasonably Achievable). use appropriate shields
(such as lead aprons and thyroid collars). limit beam size and time of exposure. maintain the
safety of yourself, patient, and others accompanying the patient.
4. Equipment and Technical Proficiency
operate imaging equipment properly and safely. make appropriate selections of exposure
parameters, taking into account the body part and the size of the patient. limit duplicate images
but still maintain image quality. report equipment malfunction.
5. Positioning and Image Acquisition
accurately position the patient related to the examination requested. use topical and gross
landmarks and immobilize if required. ensure that images are reviewed for quality (contrast,
sharpness, centering). ensure images conform to digital/diagnostic standards before sending to
be reported.
[Link] Prevention and Control
follow standard precautions (hand hygiene, personal protective equipment). utilize on
equipment and surfaces between patients. prevent cross-contamination in any clinical settings.
7. Documentation and Record Keeping
document information of the procedure, including exposure parameters and findings. keep
accurate and confidential records of the patient. upload images to PACS in a timely manner and
appropriately label.
[Link] and Legal Responsibilities
respect the patients privacy, confidentiality, and dignity. follow codes of conduct. report incidents,
or concerns in a timely manner and professionally.
8. Emergency Response
Be aware of adverse responses (eg to contrast media) and respond quickly.
Deliver first aid or emergency assistance until help arrives.
Know emergency procedures and where the equipment is located.
Conclusion
Radiographers do just take images, they are healthcare professionals with responsibilities for
patient care and safety and for making a diagnostic image. Their role is twofold requiring
technical precision and interaction with compassion. It should be an understanding, that if
everything possible is done for them (the patient) it is considered a successful radiological
service, and they should trust you.